The Indiana AHPERD will award four (4) $500 scholarships
(applicable to tuition only at an Indiana college or university)
to graduating Indiana high school seniors who plan to major in
health education, physical education, recreation, dance education,
or allied areas (including sport administration) at an Indiana
college or university. Majors in such fields as pre-medicine, nursing,
physical therapy, engineering, dental hygiene, and other health
professions are NOT within the fields represented in IAHPERD and
cannot be considered for these scholarships.
DIRECTIONS TO APPLICANTS: Complete
parts 1 and 2. Ask your principal to complete part 3 and have your
principal mail the application to: Karen Hatch
Wilno Drive
Marion, In 46952
765.664.8319
hatch@comteck.com
PART 1
Full Name: (F,M,L)
Date of Birth (mm/dd/yy)
Social Security Number
Parent's Names
Dad
Mom
Home Street Address:
City, St. Zip
Home Phone
High School Attending
High School Street Address:
City, St. Zip
School Phone:
Proposed Major:
Hometown Newspaper
Newspaper Address
If you have assurance of scholarships or grant-in-aid,
please explain/describe:
This application form with supporting materials must
be completed fully by the applicant and returned to:
Karen Hatch
Executive Director / Marketing Coordinator
2007 Wilno Drive
Marion, In 46952
765.664.8319 hatch@comteck.com
APPLICATION DEADLINE:
JANUARY 15. Consideration will not be given to applications
that are incomplete or are postmarked after this date.
PART 2
I. Please Attach to the Application Form the Following Information
Typed or Computer Printed:
High School Activities : List organizations, clubs, sports,
and groups in which you have been active. Include honors and
offices held.
Community Activities : List community activities in which
you have participated during your high school years.
Applicant’s Statement : Prepare a 1-2 page statement
in which you describe your career goals and plans, your qualifications
for this scholarship, and your need for financial assistance.
II. Request Letters of Recommendation from two (2) adults who know
your qualifications and include each in a sealed envelope when
submitting application materials. Mailing instructions : All application
materials, including signed application, responses to items A-C
above, two letters of recommendations, and Part 3 completed by
the school principal should be mailed together in one large envelope.
It should be sent from your principal’s office.
Applicant’s Signature ____________________ Date _____________
Part 3: To be Completed by Principal
Applicant’s rank in class:
Number of students in applicant’s
class:
GPA (minimum for consideration: 3.0 or B)
Recommendation Statement: (Use additional sheet if necessary)
Transcript: a copy must be submitted as part of the application materials
Principal’s Signature _________________________________
Date __________
Principal’s Name (Typed) ____________________School Phone
_____________
Mail with materials provided by student (letters of recommendation, application form, responses to items A-C) to the following address postmarked no later than January 15:
Karen Hatch
Executive Director / Marketing Coordinator
2007 Wilno Drive
Marion, In 46952
765.664.8319 hatch@comteck.com
